Active NPI
Kristen Alexandria Widmayer, DPT
- Physical Therapist
- Morehead City, NC
National Provider Identifier
1124355433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12270
- Practice address
- 147 Hwy 24
Hestron Plaza, Suite 102
Morehead City, NC 28557 - Phone
- (252) 726-4000
- NPI assigned
- Nov 6, 2009
- Last updated
- Aug 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12270 | NC | Primary |
Addresses
Primary practice location
147 Hwy 24
Hestron Plaza, Suite 102
Morehead City, NC 28557
Mailing address
PO Box 158
Morehead City, NC 28557-0158
Phone (252) 726-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12270 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| QRM Plus Florida LLC | Physical Therapist | Current | Accepting new patients |
Locations
670 Flushing Ave
Ste 307
Brooklyn, NY 11206
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1124355433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "285570158",
"telephone_number": "252-726-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 HWY 24",
"address_2": "HESTRON PLAZA, SUITE 102",
"city": "MOREHEAD CITY",
"state": "NC",
"postal_code": "28557",
"telephone_number": "252-726-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDMAYER",
"first_name": "KRISTEN",
"middle_name": "ALEXANDRIA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-06",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "12270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Morehead City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.